Unilateral spermatic cord torsion without ipsilateral spermatogenetic material: effects on testicular blood flow and fertility potential

Güngör, Fırat; Karagüzel, Güngör; Yıldız, Akın; Melikoğlu, Mustafa

doi:10.1007/s00240-003-0377-3

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…Several mechanisms, including an immunological phenomenon, release of acrosomal enzymes, blood flow alterations, an underlying congenital testicular defect, presence of underlying defect of spermatogenesis, paired neuroendocrine or vasomotor response during torsion and subclinical attacks of contralateral testicular torsion, are claimed to be responsible on this issue. 2,4,[20][21][22][23][24][25] In the testicular tissue, MTBS is used to assess histopathological damage. It is based on the evaluation of progressive degeneration of the germinal epithelium.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] However, some studies have opposed the bilateral effects of spermatic cord torsion. 5,6 Its contralateral effects have been the focus of major attention because such a damage carries a high risk for infertility.…”

Section: Introductionmentioning

confidence: 98%

“…Ipsilateral orchiectomy is recommended to prevent contralateral damage and infertility if a prolonged period has elapsed after unilateral spermatic cord torsion. 4 Furthermore, several enzymes and drugs, including allopurinol, superoxide dismutase, catalase, gabexate mesilate, melatonin, epidermal growth factor, ATP-MgCl 2 , anti-oxidant vitamins, l-carnitine and N-acetylcysteine, were used to prevent ischaemia-reperfusion (I/R) injury. 2,3,7,8 The peroxisome proliferator-activated receptor-gamma (PPAR-g) is a member of the nuclear hormone receptor superfamily that is involved in several physiological processes, such as glucose homeostasis, cellular differentiation, regulation of lipid and lipoprotein metabolism, as well as in pathological states, including atherosclerosis, inflammation, cancer, infertility and demyelination.…”

Section: Introductionmentioning

confidence: 99%

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Rosiglitazone, an Agonist of Peroxisome Proliferator‐activated Receptor‐gamma, Prevents Contralateral Testicular Ischaemia–reperfusion Injury in Prepubertal Rats

İnan

Başaran

Dökmeci³

et al. 2007

Clin Exp Pharma Physio

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1. Rosiglitazone plays a positive role in the reparation of ischaemia-reperfusion (I/R) injury in different tissues. Thus, we examined its biochemical and histological effects on the contralateral testes to determine whether exogenous rosiglitazone affords any protection against testicular damage. 2. Forty-eight prepubertal male Wistar-Albino rats were divided into six groups. Testicular torsion was created by rotating the right testis 720 degrees in a clockwise direction for 5 h in all groups except group I, which was the sham-control group. In group II, bilateral orchiectomy was performed following the torsion period. After detorsion both testes were removed in the fifth hour in group III and on the seventh day in group IV. In group V, one-shot rosiglitazone (4 mg/kg) was administered 40 min before detorsion and both testes were removed following the torsion period. In group VI, rosiglitazone was administered (4 mg/kg) 40 min before detorsion and for 7 days, and then both testes were harvested. The tissue levels of malondialdehyde (MDA) were measured and mean testicular biopsy score (MTBS) and mean seminiferous tubule diameter (MSTD) were examined. Immunoexpression of endothelial nitric oxide synthase (eNOS) in testes tissues was investigated by immunohistochemical studies. 3. In the contralateral testis, the MTBS and MSTD values of group VI were significantly higher than those in group IV. Immunohistochemically, mild eNOS immunostaining was present in the germ cells of the contralateral testes in group IV after I/R. In group VI, intense eNOS immunoreactivity was seen in the contralateral testes. 4. Rosiglitazone reduces contralateral testicular damage formed after unilateral testicular torsion and alleviates the oxidative events.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Rosiglitazone, an Agonist of Peroxisome Proliferator‐activated Receptor‐gamma, Prevents Contralateral Testicular Ischaemia–reperfusion Injury in Prepubertal Rats

İnan

Başaran

Dökmeci³

et al. 2007

Clin Exp Pharma Physio

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“…After unilateral testicular torsion, the reflexive decrease of blood flow is suggested as a common and major pathway of contralateral testicular injury. The damage encountered in the contralateral testis following unilateral testicular torsion may be due to hypoxia that exceeds a critical level, as well as the duration of the progressive decrease in blood flow 20–24 . However, Ozokutan et al 9 .…”

Section: Discussionmentioning

confidence: 99%

Methylene Blue Increases Contralateral Testicular Ischaemia–reperfusion Injury After Unilateral Testicular Torsion

İnan

Başaran²,

Dökmeci³

et al. 2007

Clin Exp Pharma Physio

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1. Testicular ischaemia-reperfusion injury is commonly seen in childhood. Infertility occurs in 25% of patients after unilateral testicular ischaemia. It is has been reported that methylene blue has a positive effect in the reparation of ischaemia-reperfusion injury in different tissues. Therefore, we hypothesized that methylene blue may prevent the hazardous effects of ischaemia-reperfusion injury in testicular tissue after unilateral testicular torsion. 2. Thirty-two prepubertal Wistar-albino rats were divided into four groups. Testicular torsion was created by rotating the right testis 720 degrees in a clockwise direction for 5 h in all groups except for Group C, which was the sham control group. In Group T, bilateral orchiectomy was performed following the torsion period. In Group TD, both testes were removed 5 days after the torsion period. In Group MB, methylene blue (1 mg/kg, i.p.) was administered 40 min before detorsion and once daily over 5 days; then, both testes were harvested. Tissue levels of malondialdehyde (MDA), serum levels of creatine kinase (CK), mean testicular biopsy score (MTBS) and mean seminifer tubule diameter (MSTD) were determined. 3. There was a significant difference in MTBS between Groups T and TD (P < 0.05) in both ipsilateral and contralateral testes. In the contralateral testis, treatment with methylene blue decreased MTBS and MSTD (P < 0.05) and increased MDA levels (P < 0.05). In Group T, mean serum CK concentrations were higher than in any of the other groups (P < 0.05). 4. After 5 h of unilateral testicular torsion and a 5 day reperfusion period, serious tissue damage occurred on both the ipsilateral and contralateral sides. Serum CK concentrations may be an indicator for ischaemia, but not for ischaemia-reperfusion injury. Contrary to our hypothesis, methylene blue increased contralateral testicular damage after unilateral testicular torsion and exacerbated oxidative events.

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“…There is controversy about the effects of ischemia and reperfusion on the ipsilateral and contralateral testes after unilateral torsion and detorsion of the spermatic cord (26). One finding is that the absence of spermatogenetic material in unilateral spermatic cord torsion may reduce contralateral blood flow and fertility potential (27). Conflicting reports have led to two distinct and opposite recommendations regarding surgical intervention: detorsion and preservation of the ipsilateral testis, or ipsilateral orchiectomy to preserve contralateral fertility.…”

Section: Figurementioning

confidence: 98%

Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans

Cakmak

Akpınar

Ekinci

et al. 2008

Fertility and Sterility

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Unilateral spermatic cord torsion without ipsilateral spermatogenetic material: effects on testicular blood flow and fertility potential

Cited by 11 publications

References 20 publications

Rosiglitazone, an Agonist of Peroxisome Proliferator‐activated Receptor‐gamma, Prevents Contralateral Testicular Ischaemia–reperfusion Injury in Prepubertal Rats

Rosiglitazone, an Agonist of Peroxisome Proliferator‐activated Receptor‐gamma, Prevents Contralateral Testicular Ischaemia–reperfusion Injury in Prepubertal Rats

Methylene Blue Increases Contralateral Testicular Ischaemia–reperfusion Injury After Unilateral Testicular Torsion

Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans

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